MEDICARE: SORENSEN CHIROPRACTIC, A PROFESSIONAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	19599	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DC0195990	OTHER	CA	MEDICARE

General Provider Information

NPI Number	:	1700221926
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SORENSEN CHIROPRACTIC, A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	1650 SIERRA AVE
Second Line	:	SUITE 201
City	:	YUBA CITY
State	:	CA
Zip	:	95993-8986
Country	:	US
Telephone Number	:	530-671-4616
Fax Number	:	530-671-6062

Provider Business Practice Location Address
First Line	:	1095 STAFFORD WAY STE C
Second Line	:
City	:	YUBA CITY
State	:	CA
Zip	:	95991-3333
Country	:	US
Telephone Number	:	530-671-4616
Fax Number	:	530-671-6062

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. F SCOTT SORENSEN
Credential	:	DC
Telephone Number	:	530-671-4616

Provider Enumeration Date	:	05/01/2013
Last Update Date	:	12/07/2016

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